Monkeypox: All you need to know about the disease
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Experts involved in the man’s case have called for people to be aware of the possibility of co-infection between Covid and monkeypox. A group of scientists reported the 36-year-old’s case in an article published in the Journal of Infection.
The man developed a fever up to 39C, fatigue, headache and sore throat nine days after returning to Italy from Spain, where he had been from June 16 to 20. He tested positive for the Omicron variant on July 2, the same day a rash started to appear on his left arm. Blisters broke out on his torso, lower limbs, face and bottom a day later.
Three days after testing positive for Covid, the man went to the emergency room at University Hospital in Catania, Sicily, suffering from increasing pain. From there he was transferred to an infectious diseases unit. The lesions and the fact he had been in Spain led medics to suspect monkeypox. At the time of his visit, Spain was the European country most affected by monkeypox.
Samples taken on July 6 proved positive for monkeypox and HIV. The man had previously tested negative for HIV in September last year, according to the article’s authors. The monkeypox strain identified through the samples belonged to a West African variant responsible for the Spanish outbreak.
The patient was treated with Sotrovimab, a monoclonal antibody administered intravenously. Most of the man’s symptoms had disappeared by July 9, but he was still positive for COVID-19 and monkeypox two days later, despite the absence of new lesions.
The patient was able to go home, but had to self-isolate. The authors conclude: “Clinicians should be aware of the possibility of co-infection with SARS-CoV-2 and monkeypox virus, especially in individuals who have recently travelled to areas of monkeypox epidemics.
“Health systems should be aware of this possibility.”
They added while he suffered quite severe symptoms, this was the only reported case of co-infection with monkeypox virus, SARS-CoV-2 and HIV so it was not possible to say this combination might worsen the patient’s condition.
The authors urged healthcare providers to be aware of the case and promote diagnostic testing in subjects identified as high risk in order to contain the spread of monkeypox. More than 41,000 cases of monkeypox and 12 deaths have been reported from 96 countries, with the majority of cases in United States, according to the World Health Organization.
The UK had 3,207 confirmed cases as of yesterday (August 24) including 3,058 in England, 78 in Scotland, 27 in Northern Ireland and 44 in Wales. Italy had reported 714 cases as of Tuesday (August 23).
The WHO declared the outbreak a global health emergency in July. Case numbers reported globally fell 21 percent in the week ending August 21, after a month-long trend of rising infections, according to the WHO’s latest epidemiological report.
WHO Director-General Tedros Adhanom Ghebreyesus said in a press briefing today (August 25): “There are signs the outbreak is slowing in Europe, where a combination of effective public health measures, behavior change and vaccination is helping to prevent transmission.”
However, more than a dozen countries saw a rise in weekly case numbers with the highest increase reported in the US. More than 34 percent of the current global case count is in the country. The WHO said infections in the Americas region had shown “a continuing steep rise” in the previous week.
It was announced this week that British scientists behind one of the major therapeutic COVID-19 trials have turned their focus onto treatments for monkeypox.
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The team from Oxford University behind the so-called RECOVERY trial – which honed in on four effective Covid treatments – on Tuesday unveiled a new trial, dubbed PLATINUM, to confirm whether SIGA Technologies’ (SIGA.O) tecovirimat is an effective treatment for monkeypox.
Although there are vaccines developed for closely related smallpox which can reduce the risk of catching monkeypox, there are currently no treatments proven to help hasten recovery in those who develop the disease.
The virus is transmitted chiefly through close contact with an infected person. It typically causes mild symptoms including fever, rash, swollen lymph nodes and pus-filled skin lesions. Severe cases can occur, though people tend to recover within two to four weeks, according to the WHO.
Siga’s drug, branded Tpoxx, has been cleared to treat diseases caused by the family of orthopoxvirus, which includes smallpox, monkeypox and cowpox by the European Union and UK, but due to limited trial data it is generally only used in severe cases in Britain.
Since smallpox has been eradicated, and cases of monkeypox and cowpox typically occur sporadically, studies to assess the effectiveness of the drug in infected people have so far not been carried out.
Instead, its effectiveness is based on studies in animals infected with lethal doses of orthopoxviruses, as well tests of the medicine’s effects in healthy humans.
Sir Peter Horby, Professor of Emerging Infections and Global Health at the University of Oxford and the director of the new Pandemic Sciences Institute, said: “I’m hoping that we can have a result before Christmas, but it depends on the rate of recruitment.”
Meanwhile, the only approved monkeypox vaccine, made by Danish company Bavarian Nordic (BAVA.CO), is in short supply, pushing countries to stretch existing stocks.
Bavarian Nordic said on Wednesday it was exploring the viability of using technically expired doses to help bridge a growing gap between demand and supply due to the current outbreak.
Chief Executive Paul Chaplin said current global demand for the vaccine is exceeding the company’s ability to deliver.
Mr Chaplin said: “We are gearing up expanding manufacturing capacity to deliver that demand as soon as we can.”
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